The combined application of oligoclonal bands in cerebrospinal fluid and IgG intrathecal synthesis indicators and biochemical markers in the diagnosis of multiple sclerosis
10.3760/cma.j.cn112150-20231212-00433
- VernacularTitle:脑脊液寡克隆区带和IgG鞘内合成指标及生化标志物联合应用在多发性硬化鉴别诊断中的价值
- Author:
Kelin CHEN
1
;
Junchao JIANG
;
Wencan JIANG
;
Lijuan WANG
;
Siwen LI
;
Ziwei LIU
;
Yuyu GU
;
Guojun ZHANG
Author Information
1. 首都医科大学附属北京天坛医院实验诊断中心 北京市免疫试剂临床工程技术研究中心 国家药品监督管理局体外诊断试剂质量控制重点实验室，北京 100070
- Keywords:
Multiple sclerosis;
Oligoclonal band;
Differential diagnosis;
Case-control studies
- From:
Chinese Journal of Preventive Medicine
2024;58(8):1171-1176
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To establish and verify a diagnostic model for distinguishing multiple sclerosis (MS) from other neurological diseases with similar symptoms by usingcerebrospinal fluid oligoclonal band (CSF-OCB)combined with IgG intrathecal synthesis indicators and biochemical markers.Methods:Multiple sclerosis (MS) patients admitted to the Neurology Department of Beijing Tiantan Hospital affiliated with Capital Medical University from January 2014 to December 2022 were selected as the case group, while patients with similar neurological symptoms were selected as the control group. Using the case-control study design, a retrospective analysis was conducted on the detection of age, gender, oligoclonal bands in cerebrospinal fluid, IgG intrathecal synthesis indicators and biochemical indicators for all study subjects. The differential diagnosis model was determined by the multiple logistic regression analysis, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of the differential diagnosis model for neurological diseases with similar symptoms to MS and other conditions.Results:This study included 167 patients in the case group and 335 patients in the control group, of which 128 patients in the case group and 265 patients in the control group were used to construct the model, and 39 patients in the case group and 70 patients in the control group were used for model validation. The differential diagnostic model constructed by a multivariate logistic regression model was Y=0.871×CSF-OCB-0.051×CSFprotein-0.231×CSFchloride+1.183×gender-0.036×LDH+35.770. The model showed that the area under the curve, sensitivity and specificity were respectively 0.916, 87.3% and 87.6%. The Delong test results showed that the diagnostic efficacy of the model was significantly different from OCB, IgG intrathecal synthesis indicators, and OCB combined with IgG intrathecal synthesis indicators ( P<0.05). The new model validation showed that the actual diagnostic consistency rate for the MS group was 84.6%, while the actual diagnostic consistency rate for the control group was 90.0%. Conclusion:This study combines OCB, IgG intrathecal synthesis indicators, and biochemical indicators to establish a diagnostic prediction model for neurological diseases with similar clinical symptoms in MS. This model may have good differential diagnostic value and can better assist clinical diagnosis in the early stages of disease progression in MS patients.
